(844) 967-1917
Regence

Bronze Essential 8000 With 4 Copay No Deductible Office Visits UW Medicine

Plan Overview

Combined Medical and Drug Deductible
  • Individual: $8,000
  • Family: $16,000
  • Per Person: $8,000
Combined Medical and Drug Out of Pocket Maximum
  • Individual: $8,700
  • Family: $17,400
  • Per Person: $8,700

Office Visit

Primary Doctor
  • CoPay: $60.00 Copay with deductible
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered
  • Benefit Explanation: The first 4 In-Network PCP, Specialists and Urgent Care office visits combined per calendar year; are not subject to the deductible.
Specialist
  • CoPay: $60.00 Copay with deductible
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered
  • Benefit Explanation: The first 4 In-Network PCP, Specialists and Urgent Care office visits combined per calendar year; are not subject to the deductible.

Prescription Drug Information

Preferred Brand Drugs
  • CoPay: Not Applicable
  • CoInsurance: 20.00% Coinsurance after deductible
  • Covered: Covered
  • Limit Quantity: 30
  • Limit Unit : Days per Month
  • Benefit Explanation: Coverage is limited to a 30-day supply retail or 90-day supply mail order per fill or refill.
Non Preferred Brand Drugs
  • CoPay: Not Applicable
  • CoInsurance: 50.00% Coinsurance after deductible
  • Covered: Covered
  • Limit Quantity: 30
  • Limit Unit : Days per Month
  • Benefit Explanation: Coverage is limited to a 30-day supply retail or 90-day supply mail order per fill or refill.
Generic Drugs
  • CoPay: $15.00
  • CoInsurance: Not Applicable
  • Covered: Covered
  • Limit Quantity: 30
  • Limit Unit : Days per Month
  • Benefit Explanation: Coverage is limited to a 30-day supply retail or 90-day supply mail order per fill or refill. 87718WA2170004 both WAF009, WAF013 apply; 87718WA2170009 both WAF009, WAF013 apply; 87718WA2170010 both WAF009, WAF013 apply; 87718WA2170012 both WAF009, WAF013 apply. Generic Drug cost share represents Preferred Generic Drugs in Tier 1. Non-preferred Generic Drugs that fall into Tier 2 are covered at a higher cost share.
Specialty Drugs
  • CoPay: Not Applicable
  • CoInsurance: 40.00% Coinsurance after deductible
  • Covered: Covered
  • Limit Quantity: 30
  • Limit Unit : Days per Month
  • Benefit Explanation: First fill allowed at a retail pharmacy. Additional fills must be provided at a specialty pharmacy. Coverage is limited to a 30-day supply for specialty and self-administrable cancer chemotherapy medications from a specialty pharmacy per fill or refill. Specialty medications that fall into Tier 6 Specialty are non-preferred medications and covered at 50% coinsurance after deductible.

Inpatient Coverage

Hospital Services
  • CoPay: Not Applicable
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered
Inpatient Services
  • CoPay: Not Applicable
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered

Emergency and Urgent Care

Emergency Room
  • CoPay: Not Applicable
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered
  • Benefit Explanation: Out of service area coverage is available.
Urgent Care Facility
  • CoPay: $60.00 Copay with deductible
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered
  • Benefit Explanation: The first 4 In-Network PCP, Specialists and Urgent Care office visits combined per calendar year; are not subject to the deductible.

Maternity

Labor and Delivery Hospital Stay
  • CoPay: Not Applicable
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered
Pre and Postnatal Office Visit
  • CoPay: Not Applicable
  • CoInsurance: 10.00% Coinsurance after deductible
  • Covered: Covered

Vision

Routine Eye Exams For Children
  • CoPay: No Charge
  • CoInsurance: No Charge
  • Covered: Covered
  • Limit Quantity: 1
  • Limit Unit : Exam(s) per Year

Major Dental Care

Routine Dental Checkups for Children
  • Covered: Not Covered
Basic Dental Care - Child
  • Covered: Not Covered
Major Dental Care - Child
  • Covered: Not Covered
Related Articles
You may be interested in these relevant articles from across the HealthMarkets.com network.
© 2021 HealthMarkets Insurance Agency. All rights reserved.
Attention: This website is operated by HealthMarkets Insurance Agency and is not the Health Insurance Marketplace® website. In offering this website, HealthMarkets Insurance Agency is required to comply with all applicable federal laws, including the standards established under 45 C.F.R. § 155.220(c) and (d) and standards established under 45 C.F.R. § 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans (QHPs) being offered in your state through the Health Insurance Marketplace® website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace® website at HealthCare.gov.
HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.
1. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in a health plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.
2. HealthMarkets is ranked “Excellent” (5 out of 5 stars) by 92% of customers on Trustpilot: Based on 3,101 customer reviews on Trustpilot in the health insurance agency category as of 4/29/21. Learn more at www.trustpilot.com/review/healthmarkets.com
3. Premium subsidies vary by address and subject to eligibility. Those with incomes between 100% and 150% of the federal poverty level (FPL) may qualify for a zero-dollar premium silver plan (after tax credits). They may also qualify for a zero-dollar premium bronze plan (after tax credits). Cost sharing (deductibles and coinsurance) may be higher.
46513-HM-1020 46512-HM-0121
HealthMarkets Insurance Agency BBB Business Review
Verified Badge